Enlarged Prostate: Herbal Therapy

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Enlarged Prostate: Herbal Therapy

Topic Overview

Herbal supplements that may be used to relieve symptoms of benign prostatic hyperplasia (BPH) include saw palmetto, beta-sitosterol, Pygeum africanum, and Cernilton.

In general, the trials using these substances have been short, and self-improvement scores can be biased. Different preparations are available for each substance, and they are not always equivalent. So the results cannot be generalized to all preparations, and results may vary.

Talk with your doctor before starting any herbal therapy.

Saw palmetto

Saw palmetto is made from the ripe berries of the plant Serenoa repens, the dwarf palm. The dwarf palm is a native plant in America.

Studies conflict on whether saw palmetto improves men's symptoms. In one study, men taking saw palmetto were no better than those who took a placebo.1

But one review of trials on different saw palmetto preparations report that more men rated their symptoms improved while using saw palmetto compared with a placebo.2 The reviews also report that:2

  • Saw palmetto improved symptoms just as well as tamsulosin and finasteride.
  • The risk of erection problems when using saw palmetto was less than that of finasteride.

See more information on saw palmetto.

Beta-sitosterol extract

Beta-sitosterol is an extract made from Hypoxis rooperi, the South African star grass.

One review of trials using beta-sitosterol reports that beta-sitosterol reduced the International Prostate Symptoms Score (I-PSS) more than a placebo did.2

See more information on beta-sitosterol.

Pygeum africanum

P. africanum extract is made from the bark of the African plum tree.

One review of 18 studies shows that P. africanum improved symptoms compared to a placebo. It also increased urine flow and decreased the amount of urine retained in the bladder.2 But these studies did not follow up for very long. The type of extract and how much was used was also different in each study, so the results are hard to compare.


Cernilton is an extract made from Secale cereale, or rye grass pollen.

In two studies, more men who took rye grass pollen said they had improved symptoms, compared to men who took a placebo.2 But both studies were small and had no long-term follow-up. Also, it was not known in either study how the extract was made or how much the men used.

See more information on rye grass pollen extract.



  1. Bent S, et al. (2006). Saw palmetto for benign prostatic hyperplasia. New England Journal of Medicine, 354(6): 557–566.
  2. Webber R (2006). Benign prostatic hyperplasia, search date May 2005. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.


By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology
Last Revised June 25, 2010

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